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General NPI Number Information
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NPI Number | 1831183383
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Entity Type | Individual
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Provider Name | JOHN S. EDELEN M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/09/2005
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Last Update Date | 06/24/2025
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Provider Practice Location Address
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Address Line | 15 ALTARINDA RD STE 112
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City | ORINDA
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State | CA
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Zip | 94563-2607
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Country | US
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Telephone | 707-718-5988
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 130
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City | VACAVILLE
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State | CA
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Zip | 95696-0130
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Country | US
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Telephone | 707-718-5988
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | G26272
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License Number State | CA
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